Discussion of public health and health care policy, from a public health perspective. The U.S. spends more on medical services than any other country, but we get less for it. Major reasons include lack of universal access, unequal treatment, and underinvestment in public health and social welfare. We will critically examine the economics, politics and sociology of health and illness in the U.S. and the world.

Wednesday, October 30, 2013

Bad news?

Apparently so. Specifically, the bad news is that we're living longer. The linked analysis by Pandya et al is concerned specifically with heart disease. This is one area in which medical advances have unquestionably extended life. We haven't reduced the incidence of cardiovascular disease by much, but it doesn't kill people nearly as quickly as it used to. Fortunately, rates of smoking have declined, but the prevalence of obesity and diabetes is increasing. More people with heart disease, living longer, means a lot more people living with heart disease. These authors predict the prevalence will increase from about 11% for men and 8.6% for women today to 14.5% and 10.4%, respectively by 2030. And that will mean an enormous increase in disability, people living with poor quality of life, and of course Medicare spending.

What could be worse than that? If, as many predict, scientists figure out how to slow down the aging process by even just a little bit, say adding 2.2 years to life expectancy, that will be worth $7.1 trillion in benefits over 50 years, if we say a healthy year of life is worth just $100,000. But Medicare costs would increase by $3 trillion per year. (Social Security would go up by about $90 billion, which used to be a lot of money. All of this is in constant 2010 dollars.)

The problem is, are we willing to pay for that? We certainly could pay for it. We live in the wealthiest society ever. And we're all hoping to be in that old category some day. So shouldn't we decide, "This is a good way to spend our money"? Well, it doesn't look that way because rich people would have to pony up. And there seems to be a very strong correlation in this country between wealth and psychopathy.